轻度慢性肾功能不全对非体外循环冠状动脉旁路移植术后疗效影响

The effect of mild chronic renal insufficiency on the outcome of off⁃pump coronary artery bypass grafting

目的 探讨术前轻度慢性肾功能不全对非体外循环心脏不停跳冠状动脉旁路移植术(OPCABG)早期疗效的影响。方法 回顾性分析自2009年1月至2019年11月收治的53例术前存在轻度慢性肾功能不全(133μmol/L≤肌酐<442μmol/L)的单纯OPCABG手术患者的临床资料(A组),选取同期的120例术前肾功能正常的单纯OPCABG患者为B组,对围术期各项数据和术后疗效进行分析。结果 A组患者的吸烟史、高血压病史比例显著高于B组,差异有统计学意义(P<0.05)。A组住院费用和红细胞使用量明显高于B组,差异有统计学意义(P<0.05)。两组术后严重并发症的发生率以及呼吸机使用时间、ICU停留时间和住院时间等方面比较,差异无统计学意义(P>0.05)。结论 接受OPCABG手术的轻度慢性肾功能不全患者在住院费用和红细胞使用量方面明显高于肾功能正常患者。两组在术后严重并发症的发生率以及呼吸机使用时间、ICU停留时间和住院时间等方面并无明显差异。术前轻度慢性肾功能不全对CABG患者的术后近期疗效无显著影响。

Objective To investigate the effect of preoperative mild chronic renal insufficiency on the early curative effect of off⁃pump cardiopulmonary bypass grafting(OPCABG).Methods The clinical data of 53 patients with mild chronic renal insufficiency who un⁃derwent OPCABG surgery before surgery were retrospectively analyzed from January 2009 to November 2019(Group A).A total of 120 OPCABG patients with normal renal function before operation were selected as group B.The perioperative data and postoperative effica⁃cy of the two groups were analyzed.Results The proportion of smoking history and hypertension history in group A was significantly higher than that in group B,with statistical significance(P<0.05).The hospitalization cost and red blood cell consumption in group A were significantly higher than those in group B,with statistical significance(P<0.05).There were no significant differences between the two groups in the incidence of postoperative serious complications,ventilator use time,ICU stay time and hospital stay.Conclusion Patients with mild chronic renal insufficiency who underwent OPCABG surgery had significantly higher hospital costs and red blood cell use than patients with normal renal function.There were no significant differences between the two groups in the inci⁃dence of postoperative serious complications,ventilator use time,ICU stay time and hospital stay.Preoperative mild chronic renal insuf⁃ficiency had no significant effect on the short⁃term postoperative outcome of OPCABG patients.